<div id="mainContents">
    <h1 class="heading01">お問合せ</h1>
    
    		<form name="data_entry_frm" id="data_entry_frm" action="info.php" method="post">
    <div class="mfpSection">
      <p><img src="images/txt_step02.gif" alt="入力内容の確認" width="635" height="30" /></p>
      <p class="text error">内容を修正したい場合は、ブラウザの「戻る」ボタンは使わずに、下にある「戻る」ボタンを押して、<br />再度内容を入力してください。</p>
      <h2 class="mainTitle"><img src="images/petrochemicals_mailform_input.gif" alt="お問合せ内容を入力してください。" width="635" height="35" /></h2>
      <p class="text">「<em>*</em>」の項目は必ず入力して下さい。</p>
      <table class="dataTable">
        <tr>
          <th class="valignMiddle"><em>*</em>お問合せ内容</th>
          <td><?php if(isset($_POST['inquiry'])) echo trim($_POST['inquiry']); ?></td>
        </tr>
      </table>
      
      <h2 class="mainTitle"><img src="images/petrochemicals_mailform_renrakusaki.gif" alt="" width="635" height="35" /></h2>
      <table class="dataTable">
        <tr>
          <th><em>*</em>お名前</th>
          <td><?php if(isset($_POST['lastName01'])) echo trim($_POST['lastName01']); ?>&nbsp;<?php if(isset($_POST['name01'])) echo trim($_POST['name01']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em>フリガナ</th>
          <td><?php if(isset($_POST['lastName02'])) echo trim($_POST['lastName02']); ?>&nbsp;<?php if(isset($_POST['name02'])) echo trim($_POST['name02']); ?></td>
        </tr>
        
        <tr>
          <th>会社名・部署名</th>
          <td><?php if(isset($_POST['sign'])) echo trim($_POST['sign']); ?></td>
        </tr>
      </table>
      
      <h2 class="mainTitle"><img src="images/petrochemicals_mailform_kaitousaki.gif" alt="回答先として、ご住所、電話番号、FAX番号、E-Mailアドレスのいずれかを入力してください。" width="635" height="35" /></h2>
      <table class="dataTable">
        <tr>
          <th><em>*</em>郵便番号</th>
          <td><?php if(isset($_POST['postalCode'])) echo trim($_POST['postalCode']); ?> - <?php if(isset($_POST['name03'])) echo trim($_POST['name03']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em>都道府県</th>
          <td><?php if(isset($_POST['select_option'])) echo trim($_POST['select_option']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em><label for="county">市区郡</label></th>
          <td><?php if(isset($_POST['county'])) echo trim($_POST['county']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em><label for="street">町村番地</label></th>
          <td><?php if(isset($_POST['street'])) echo trim($_POST['street']); ?></td>
        </tr>
        
        <tr>
          <th><label for="apartmentName">アパート・マンション名</label></th>
          <td><?php if(isset($_POST['apartmentName'])) echo trim($_POST['apartmentName']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em>電話番号</th>
          <td><?php if(isset($_POST['phoneNumber01'])) echo trim($_POST['phoneNumber01']); ?> - <?php if(isset($_POST['phoneNumber02'])) echo trim($_POST['phoneNumber02']); ?> - <?php if(isset($_POST['phoneNumber03'])) echo trim($_POST['phoneNumber03']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em>FAX番号</th>
          <td><?php if(isset($_POST['fax01'])) echo trim($_POST['fax01']); ?> - <?php if(isset($_POST['fax02'])) echo trim($_POST['fax02']); ?> - <?php if(isset($_POST['fax03'])) echo trim($_POST['fax03']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em><label for="email01">E-mailアドレス</label></th>
          <td><?php if(isset($_POST['email01'])) echo trim($_POST['email01']); ?></td>
        </tr>
        
        <tr>
          <th><em>*</em><label for="email02">E-mailアドレス（確認）</label></th>
          <td><?php if(isset($_POST['email02'])) echo trim($_POST['email02']); ?></td>
        </tr>
      </table>
            
      <dl class="check mt0">
        <dt>個人情報開示のご確認<span>必須</span></dt>
        <dd>
          <p><?php if(isset($_POST['radio_confirm'])) echo trim($_POST['radio_confirm']);?></p>
        </dd>
      </dl><!-- / .check -->
      <input type="hidden" name="inquiry" value="<?php echo trim($_POST['inquiry']); ?>" />
      <input type="hidden" name="name01" value="<?php echo trim($_POST['name01']); ?>" />
      <input type="hidden" name="lastName01" value="<?php echo trim($_POST['lastName01']); ?>" />
      <input type="hidden" name="name02" value="<?php echo trim($_POST['name02']); ?>" />
      <input type="hidden" name="lastName02" value="<?php echo trim($_POST['lastName02']); ?>" />
      <input type="hidden" name="sign" value="<?php echo trim($_POST['sign']); ?>" />
      
      <input type="hidden" name="radio_confirm" value="<?php echo trim($_POST['radio_confirm']); ?>" />
      <ul class="btnList">
        
        <li><input type="submit" name="confirm_again" id="confirm_again" value="戻　る" class="btn" /></li>
        <li><input type="submit" name="confirm" id="confirm" value="送　信" class="btn" /></li>
      </ul>
    </div><!-- / .mfpSection -->
    </form>
  </div><!-- / #mainContents -->
  
        
  